Bridging the distance: understanding access to healthcare through stories from Gwich’in medical travellers in Northwest Territories

In northern Canada, medical travel – the movement of patients to a larger centre to access healthcare services outside their home community – is a dominant feature of the healthcare system. This qualitative study explored the medical travel experiences of Gwich’in living above the Arctic Circle in t...

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Main Authors: Crystal Milligan, Sharla Greenland, Lorna Storr, Agnes Pascal, Stephanie Irlbacher-Fox, Mark J. Dobrow
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:International Journal of Circumpolar Health
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/22423982.2024.2438430
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author Crystal Milligan
Sharla Greenland
Lorna Storr
Agnes Pascal
Stephanie Irlbacher-Fox
Mark J. Dobrow
author_facet Crystal Milligan
Sharla Greenland
Lorna Storr
Agnes Pascal
Stephanie Irlbacher-Fox
Mark J. Dobrow
author_sort Crystal Milligan
collection DOAJ
description In northern Canada, medical travel – the movement of patients to a larger centre to access healthcare services outside their home community – is a dominant feature of the healthcare system. This qualitative study explored the medical travel experiences of Gwich’in living above the Arctic Circle in the Gwich’in Settlement Area in Northwest Territories (NT). Data collection in 2020 comprised storytelling sessions with 10 Gwich’in medical travellers (6 female, 4 male). Using inductive and deductive methods with continual critical reflexivity, and guided by Gwich’in values, concerns about access to healthcare were found to be at the heart of each story. A broad conceptualisation of access was applied to understand and interpret the results according to six dimensions: accessibility, availability, affordability, adequacy, acceptability, and awareness. Situated within a context of colonialism, structural inequities and other factors relevant across the Circumpolar North, the results suggest that the NT medical travel policy framework provides only partial access to care. This article illustrates a need for healthcare and other government systems to think about policy and programmes in a more wholistic, equitable and relationship-centred way, which would help not only to bridge distances across geography, but also between peoples.
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series International Journal of Circumpolar Health
spelling doaj-art-e2ec664ab35a4918963dd7bf6f4b945a2024-12-16T07:46:10ZengTaylor & Francis GroupInternational Journal of Circumpolar Health2242-39822025-12-0184110.1080/22423982.2024.2438430Bridging the distance: understanding access to healthcare through stories from Gwich’in medical travellers in Northwest TerritoriesCrystal Milligan0Sharla Greenland1Lorna Storr2Agnes Pascal3Stephanie Irlbacher-Fox4Mark J. Dobrow5Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, CanadaGwich’in Tribal Council, Inuvik, NT, CanadaResearch Assistant, Aklavik, NT, CanadaResearch Assistant, Inuvik, NT, CanadaHotıì ts’eeda Northwest Territories SPOR Support Unit, Yellowknife, NT, CanadaInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, CanadaIn northern Canada, medical travel – the movement of patients to a larger centre to access healthcare services outside their home community – is a dominant feature of the healthcare system. This qualitative study explored the medical travel experiences of Gwich’in living above the Arctic Circle in the Gwich’in Settlement Area in Northwest Territories (NT). Data collection in 2020 comprised storytelling sessions with 10 Gwich’in medical travellers (6 female, 4 male). Using inductive and deductive methods with continual critical reflexivity, and guided by Gwich’in values, concerns about access to healthcare were found to be at the heart of each story. A broad conceptualisation of access was applied to understand and interpret the results according to six dimensions: accessibility, availability, affordability, adequacy, acceptability, and awareness. Situated within a context of colonialism, structural inequities and other factors relevant across the Circumpolar North, the results suggest that the NT medical travel policy framework provides only partial access to care. This article illustrates a need for healthcare and other government systems to think about policy and programmes in a more wholistic, equitable and relationship-centred way, which would help not only to bridge distances across geography, but also between peoples.https://www.tandfonline.com/doi/10.1080/22423982.2024.2438430Medical travelmedical transportationNorthwest TerritoriesGwich’inhealthcare accesshealth policy
spellingShingle Crystal Milligan
Sharla Greenland
Lorna Storr
Agnes Pascal
Stephanie Irlbacher-Fox
Mark J. Dobrow
Bridging the distance: understanding access to healthcare through stories from Gwich’in medical travellers in Northwest Territories
International Journal of Circumpolar Health
Medical travel
medical transportation
Northwest Territories
Gwich’in
healthcare access
health policy
title Bridging the distance: understanding access to healthcare through stories from Gwich’in medical travellers in Northwest Territories
title_full Bridging the distance: understanding access to healthcare through stories from Gwich’in medical travellers in Northwest Territories
title_fullStr Bridging the distance: understanding access to healthcare through stories from Gwich’in medical travellers in Northwest Territories
title_full_unstemmed Bridging the distance: understanding access to healthcare through stories from Gwich’in medical travellers in Northwest Territories
title_short Bridging the distance: understanding access to healthcare through stories from Gwich’in medical travellers in Northwest Territories
title_sort bridging the distance understanding access to healthcare through stories from gwich in medical travellers in northwest territories
topic Medical travel
medical transportation
Northwest Territories
Gwich’in
healthcare access
health policy
url https://www.tandfonline.com/doi/10.1080/22423982.2024.2438430
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